Feds Order More Weekend Inspections Of Nursing Homes To trap Understaffing


The authorities announced plans Friday to hack down on nursing facilities with abnormally low weekend staffing by requiring more surprise inspections be done on Saturdays and Sundays.

The federal Centers for Medicare & Medicaid Services said it will identify nursing homes that payroll records indicate low weekend staffing or they operate without a rn. Medicare will instruct state inspectors to focus on those potential violations during visits.

“Since nurse staffing is proportional towards the quality of care that residents experience, CMS is very concerned about the risk to resident safety and health that these situations may present,” the company said in a notification to convey inspection offices.

The directive comes after a Kaiser Health News analysis found there are 11 percent fewer nurses providing direct care on weekends on average, and eight percent fewer aides.

Residents as well as their families frequently complain the residents have trouble getting basic help – for example assistance going to the bathroom – on weekends. One nursing home resident in upstate New York compared his facility to a weekend “ghost town” because of the paucity of workers.

Richard Mollot, executive director of the Long-term Care Community Coalition, an advocacy group in Manhattan, welcomed the brand new edict but said hello was just necessary because state inspectors have not been properly enforcing the guidelines already on the books.

“The basic problem is america don't take this seriously,” Mollot said. “How numerous studies will we need to have, every year, decade after decade, saying it all is dependant on staffing, and there are extremely few citations for inadequate staffing and virtually all seem to be recognized as not causing any resident harm?”

CMS said it will identify potential violators by analyzing payroll records that nursing homes are actually required to submit. Those records, which became public this season, showed lower staffing than facilities had previously told inspectors during their visits, according to the KHN analysis.

“CMS takes seriously our responsibility to protect the security and quality of take care of our beneficiaries,” CMS Administrator Seema Verma said inside a statement.

The nursing home industry criticized the heightened scrutiny.

“Unfortunately, today's action by CMS will enforce policies which makes it even more complicated to meet regulatory requirements and hire staff,” said Dr. David Gifford, senior v . p . of quality and regulatory affairs in the American Healthcare Association, an industry trade group, inside a written statement. “Rather than taking proactive steps to deal with the nation's workforce shortage long-term care facilities are facing, CMS appears to be concentrating on a punitive approach which will penalize providers making it harder to hire staff to meet the shared goal of increasing staffing.”

Currently, a tenth of inspections must occur during “off hours,” which can be whether weekend, or during a weekday before 8 a.m. or after 6 p.m. But for facilities that Medicare identifies as having lower weekend staffing, half of those off-hour inspections-or 5 percent of the total – should be performed on Saturdays or Sundays.

Medicare requires nursing homes to have a rn on-site not less than eight hours every day, but according to the payroll records, a quarter of nursing facilities reported no registered nurses available at least one day throughout a three-month period. Since July, Medicare's Nursing Home Compare website for consumers has highlighted homes that lack sufficient rns and lowered their star ratings. Elderly care Compare has downgraded ratings for 1,402 of 15,600 facilities for gaps in registered nurse staffing, records show.

The new directive instructs inspectors to more thoroughly evaluate staffing at facilities Medicare flags. The edict does not necessarily mean a flurry of sudden inspections. Instead, Medicare wants heightened focus on those nursing facilities when inspectors come for their standard reviews, which occur roughly annually for many facilities.

But what may seem to become staffing scarcities in payroll records may instead be clerical problems in which nurse hours are not properly recorded, say some elderly care officials.

Katie Smith Sloan, president of LeadingAge, an association of nonprofit providers of aging services, said inside a statement that some homes continue to be can not adjust to the new data collection rules.

“We've been voicing our concerns to CMS and can continue to do so,” she said.